Not applicable.
Not applicable.
The present invention relates generally to surgical knots and techniques for tying these knots and using the knots to fix tissue within a patient. More particularly, this invention relates to a sliding and locking surgical knot and a method for forming such a knot.
The development of arthroscopic reconstructive procedures has required the passage of sutures and tying of knots down a cannula. Successful accomplishment of this goal requires both mastery of suture handling and knot tying techniques. Most sliding knots currently being used such as the Duncan loop, Roeder knot, and Tennessee slider are suitable for arthroscopic procedures, but all require the surgeon to throw additional half hitches to lock the knot or to prevent the knot from loosening. It is often difficult for the surgeon to maintain adequate tension on the sliding knot while throwing these extra hitches.
There is thus a need for a sliding and locking knot that can be used in arthroscopic surgeries that does not require an additional half hitch to lock. Also desirable is a sliding knot that does not affect suture strength, has a low knot profile, and a short learning curve to tie.
The present invention avoids the aforementioned problems associated with current knots by providing a sliding and locking knot that does not require an additional half hitch to lock and suture retaining structures having such a knot. The sliding and locking knot has a low knot profile suitable for use in surgical areas with low clearance and to avoid interference with surrounding tissue. The sliding and locking knot also maintains suture strength and is easy to form.
In one embodiment, the sliding and locking surgical knot comprises a filament and includes a post at a proximal-most end. Formed on the post is a major loop that extends to a free end at a distal-most portion of the filament. Free end is threaded through the major loop to form a minor loop. A portion of the free end encircles the major loop to form at least one coil that bisects the major loop in half. Free end is then threaded through the minor loop. The sliding and locking knot can be slid down by pulling on the post. The sliding knot can be locked without requiring an additional half hitch by pulling on the free end to close the coil around the major and minor loops and post.
The sliding and locking knot can also be connected to a suture anchor device for reattaching tissue to its surroundings. In an exemplary embodiment, the suture anchor device is a bone anchor having a body extending between a first leading end and a second trailing end, the body having thereon at least one bone engaging element. Within the body is a suture receiving aperture for receiving the sliding and locking surgical knot of the present invention.
Also provided are methods for anchoring tissue to a bony structure using the bone anchor and sliding and locking knot of the present invention. In one embodiment, the bone anchor includes a suture filament extending from the suture receiving aperture. The anchor can be inserted into a bone cavity within the bony structure with the suture filament extending out from the cavity. The torn or loose tissue can be brought proximate to the bone structure and the ends of the filament tied to form the sliding and locking knot of the present invention.
In another embodiment, the bone anchor includes a pre-formed sliding and locking knot within the suture receiving aperture. The bone anchor can be inserted into the bone cavity, while a free end of the tissue is placed through the major loop of the sliding and locking knot. When the tissue is proximate to the bone structure, the knot can be locked to effect attachment of the tissue to the bony surface.
Further features of the invention, its nature and various advantages, will be more apparent from the accompanying drawings and the following detailed description of the drawings and the preferred embodiments.